Active NPI
Anna Kim
- Ambulatory Care Registered Nurse
- Duluth, GA
National Provider Identifier
1629862842
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ambulatory Care Registered Nurse
- License
- RN269894
- Practice address
- 3805 Pleasant Hill Rd
Duluth, GA 30096-4808 - Phone
- (678) 312-7000
- NPI assigned
- Apr 4, 2025
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ambulatory Care Registered Nurse | 163WP2201X | RN269894 | GA | Primary |
Addresses
Primary practice location
3805 Pleasant Hill Rd
Duluth, GA 30096-4808
Mailing address
3805 Pleasant Hill Rd
Duluth, GA 30096-4808
Phone (678) 312-7530
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250911001086 | GA | Order and Referring Only - Nurse Practitioner | 6709389281 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN269894 | GA | MD | Ambulatory Care Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1743724800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1743724800000",
"number": "1629862842",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3805 PLEASANT HILL RD",
"city": "DULUTH",
"state": "GA",
"postal_code": "300964808",
"telephone_number": "678-312-7530"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3805 PLEASANT HILL RD",
"city": "DULUTH",
"state": "GA",
"postal_code": "300964808",
"telephone_number": "678-312-7000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "ANNA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-04-04",
"last_updated": "2025-04-04",
"certification_date": "2025-04-04",
"status": "A"
},
"taxonomies": [
{
"code": "163WP2201X",
"taxonomy_group": "",
"desc": "Registered Nurse, Ambulatory Care",
"state": "GA",
"license": "RN269894",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Duluth, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.